Sunday, March 30, 2008

Umberto Eco:Hay una maldición china que dice: ““Espero que vivas en una época interesante”

Ése es uno de nuestros problemas contemporáneos. La abundancia de información irrelevante y la dificultad de seleccionarla, y la pérdida de memoria del pasado, no digo ya la histórica. La memoria es nuestra identidad, nuestra alma. Si tú pierdes hoy la memoria, ya no hay alma, eres una bestia. Si sufres un golpe en la cabeza y pierdes la memoria, te conviertes en un vegetal. Si la memoria es el alma, disminuir mucho la memoria es disminuir mucho el alma.

For any AVM, the biggest problem or most dangerous consequence (i.e., "complication") is that it may rupture. However, many unrupturd AVMs present with seizures too, and the development of a seizure disorder (epilepsy) can certainly occur after rupture of an AVM. So, seizure disorder is regarded a second major problem associated with AVMs, be they unruptured or ruptured. In fact, the younger the patient at the time of AVM diagnosis, the higher the risk of developing a seizure disorder. Overall, this the seizure risk lies somewhere between 1-2%/yr following diagnosis, but varies according to age and whether or not the AVM has ruptured.

If an AVM (or an aneurysm associated with it) ruptures, the main complications are death and serious disability from the initial rupture itself (see above) or due to events occurring after the initial rupture. Of these events, the most important one is "rebleeding" of the AVM (i.e., it, or an aneurysm associated with it, re-ruptures and bleeds again), resulting in further permanent brain tissue injury (i.e., "infarction"). Occasionally, "cerebral vasospasm" (i.e., where, following hemorrhage, brain arteries go into severe spasm; i.e., they shut down, depriving the nearby brain tissue of oxygen and other nutrients) can occur after AVM hemorrhage (especially if the hemorrhage involves the subarachnoid space; take me to the section on Cerebral Vasospasm now). In persons surviving these complications, other complications may arise. For example, there may be some degree of obstruction (or blockage) of normal cerebrospinal fluid (CSF) flow in the brain (i.e., resulting in high-pressure build up in the brain referred to as "hydrocephalus"). This is caused by the blood clot or blood products clogging up the CSF drainage system following rupture, and it can lead to progressive, permanent brain injury. Also, following AVM rupture, parts of the brain can become electrically irritated, resulting in seizures.

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